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Child nutrition, child health, and school enrollment : a longitudinal analysis


  • Alderman, Harold
  • Behrman, Jere R.
  • Lavy, Victor
  • Menon, Rekha


Better health and nutrition are thought to improve children's performance in school, and therefore their productivity after school. Most literature ignores the fact that child health and schooling reflect behavioral choices, so the estimated impact of health and nutrition on a child's schooling reflects biases in the studies. Using an explicit dynamic model for preferred estimates, the authors use longitudinal data to investigate how children's health and nutrition affect school enrollment in rural Pakistan. They use price shocks when children were of preschool age to control for behavior determining the measure of children's health and nutrition stock. The authors find that children's health and nutrition is three times more important for enrollment than is suggested by"naive estimates"that assume that children's health and nutrition is predetermined rather that determined by household choices. Not only does improved nutrition increase enrollments, it does so more for girls, thus closing a portion of the gender gap. These results strongly reinforce the importance of using estimation methods that are consistent with the economic theory of households to explore the impact of some choice variables on others, using socioeconomic behavioral data. Private behaviors and public policies that affect the health and nutrition of children have much greater effect on school enrollment and on eventual productivity than suggested by early literature methods.

Suggested Citation

  • Alderman, Harold & Behrman, Jere R. & Lavy, Victor & Menon, Rekha, 1997. "Child nutrition, child health, and school enrollment : a longitudinal analysis," Policy Research Working Paper Series 1700, The World Bank.
  • Handle: RePEc:wbk:wbrwps:1700

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    References listed on IDEAS

    1. Schultz, T.P., 1990. "Returns To Women'S Education," Papers 603, Yale - Economic Growth Center.
    2. Behrman, Jere R. & Foster, Andrew D. & Rosenzweig, Mark R., 1997. "The dynamics of agricultural production and the calorie-income relationship: Evidence from Pakistan," Journal of Econometrics, Elsevier, vol. 77(1), pages 187-207, March.
    3. Moock, Peter R. & Leslie, Joanne, 1986. "Childhood malnutrition and schooling in the Terai region of Nepal," Journal of Development Economics, Elsevier, vol. 20(1), pages 33-52.
    4. Murphy, Kevin M & Topel, Robert H, 2002. "Estimation and Inference in Two-Step Econometric Models," Journal of Business & Economic Statistics, American Statistical Association, vol. 20(1), pages 88-97, January.
    5. Deolalikar, Anil B, 1988. "Nutrition and Labor Productivity in Agriculture: Estimates for Rural South India," The Review of Economics and Statistics, MIT Press, vol. 70(3), pages 406-413, August.
    6. Jamison, Dean T., 1986. "Child malnutrition and school performance in China," Journal of Development Economics, Elsevier, vol. 20(2), pages 299-309, March.
    7. Glewwe, P. & Jacoby, H., 1993. "Delayed Primary School Enrollment and Childhood Malnutrition in Ghana, an Economic Analysis," Papers 98, World Bank - Living Standards Measurement.
    8. Jere R. Behrman & Ryan Schneider, 1993. "An International Perspective on Pakistani Human Capital Investments in the Last Quarter Century," The Pakistan Development Review, Pakistan Institute of Development Economics, vol. 32(1), pages 1-68.
    9. Behrman, Jere R, 1996. "The Impact of Health and Nutrition on Education," World Bank Research Observer, World Bank Group, vol. 11(1), pages 23-37, February.
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    1. repec:eee:labchp:v:3:y:1999:i:pb:p:2859-2939 is not listed on IDEAS
    2. Justine Burns & Malcolm Kewsell & Rebecca Thornton, 2009. "Evaluating the Impact of Health Programmes," SALDRU Working Papers 40, Southern Africa Labour and Development Research Unit, University of Cape Town.
    3. Tovar Cuevas Luis Miguel & Gustavo Adolfo García Cruz, 2007. "La producción de salud infantil en Colombia: una aproximación," REVISTA DESARROLLO Y SOCIEDAD, UNIVERSIDAD DE LOS ANDES-CEDE, March.
    4. Susan Godlonton & Malcolm Keswell, 2005. "The Impact Of Health On Poverty: Evidence From The South African Integrated Family Survey," South African Journal of Economics, Economic Society of South Africa, vol. 73(1), pages 133-148, March.
    5. Mark R. Montgomery, 2000. "Perceiving Mortality Decline," Population and Development Review, The Population Council, Inc., vol. 26(4), pages 795-819.
    6. Nasrin Dalirazar, 2002. "An International Index of Child Welfare," Working Papers wp40, Political Economy Research Institute, University of Massachusetts at Amherst.
    7. Dev, S. Mahendra & Ravi, C. & Viswanathan, Brinda & Gulati, Ashok & Ramachander, Sangamitra, 2004. "Economic liberalisation targeted programmes and household food security," MTID discussion papers 68, International Food Policy Research Institute (IFPRI).
    8. Vermeersch, Christel & Kremer, Michael, 2005. "Schools meals, educational achievement and school competition: evidence from a randomized evaluation," Policy Research Working Paper Series 3523, The World Bank.
    9. Legrand Yémélé Kana & Sylvain Dessy & Jacques Ewoudou, 2010. "Are Foster Children Made Better Off by Informal Fostering Arrangements?," Cahiers de recherche 1009, CIRPEE.
    10. World Bank, 2007. "Niger - Accelerating Growth and Achieving the Millennium Development Goals : Diagnosis and the Policy Agenda," World Bank Other Operational Studies 7658, The World Bank.


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